CAJ | 학술논문

背景与目的：18F-FDG经过由尿液排泄，膀胱中尿液的高放射性影响了膀胱病灶的检出，本研究介绍一种18F-FDG PET/CT检查中提高膀胱恶性病灶检出率的简便方法--“反复排尿再充盈法”，即：18F-FDG注射后反复饮水-排尿、最后憋尿检查。方法：回顾性分析了48例(35例原发、13例非原发)膀胱恶性肿瘤患者18F-FDG常规显像后，通过反复饮水-排尿、再憋尿进行盆腔延迟显像的结果。结果：89%的患者(43/48)在首次延迟显像时，尿液SUVmax(SUV最大值)从33.14(9～66.80)降至3.23(1.35～5.65)，差异有统计学意义，(t=8.703, P<0.01)，2次显像的平均间隔时间为2 h，而膀胱病灶的SUVmax为2.8～25.0。该延迟显像方法对膀胱癌诊断灵敏度为90.5%(19/21)、特异度为81.5%(22/27)、准确性为85.4%(41/48)。结论：反复饮水-排尿、最后憋尿情况下的盆腔延迟显像能在保持膀胱壁解剖对比的同时，有效降低膀胱尿液放射性本底、增加病灶靶/本比，进而增加膀胱癌灶检出率，且简单易行，值得推广。
배경여목적：18F-FDG경과유뇨액배설，방광중뇨액적고방사성영향료방광병조적검출，본연구개소일충18F-FDG PET/CT검사중제고방광악성병조검출솔적간편방법--“반복배뇨재충영법”，즉：18F-FDG주사후반복음수-배뇨、최후별뇨검사。방법：회고성분석료48례(35례원발、13례비원발)방광악성종류환자18F-FDG상규현상후，통과반복음수-배뇨、재별뇨진행분강연지현상적결과。결과：89%적환자(43/48)재수차연지현상시，뇨액SUVmax(SUV최대치)종33.14(9～66.80)강지3.23(1.35～5.65)，차이유통계학의의，(t=8.703, P<0.01)，2차현상적평균간격시간위2 h，이방광병조적SUVmax위2.8～25.0。해연지현상방법대방광암진단령민도위90.5%(19/21)、특이도위81.5%(22/27)、준학성위85.4%(41/48)。결론：반복음수-배뇨、최후별뇨정황하적분강연지현상능재보지방광벽해부대비적동시，유효강저방광뇨액방사성본저、증가병조파/본비，진이증가방광암조검출솔，차간단역행，치득추엄。
Background and purpose: 18F-FDG has been considered to be of limited value for the detection of bladder lesions because of interference by the 18F-FDG excreted in urine. Delayed pelvic images with“diluted and iflled bladder”use a method of 18F-FDG PET/CT with delayed images after oral hydration so as to increase the detection rate of 18F-lfuorodeoxyglucose(FDG) PET/CT imaging for the lesions of bladder. Methods:48 patients with bladder lesions(35 patients with bladder primary tumor and 13 patients with metastatic tumor) underwent 18F-FDG PET/CT detection and were required oral hydration of 1200-1800 mL water, urination frequently, holding urine when the more scan began. Lesions conifrmed by histopathology, MRI, CT or clinical follow-up at least 1 year. Results:89%(43/48) of patients were obtained good clearance and the urine SUVmax declined from 33.14(9-66.80)to 3.23(1.35-5.65) signiifcantly and the statistical difference was signiifcant (t=8.703, P<0.01). The interval time between two scan was 2 h approximately. At the same time, the SUVmax of bladder lesion was 2.8-25.0. Detection sensitivity, speciifcity and accuracy were 90.47%(19/21), 81.48%(22/27)and 85.41%(41/48), respectively. Conclusion: 18F-FDG activity in the bladder signiifcantly decreased in most patients with“diluted and iflled bladder”. The PET/CT scan can highly detect lesions of bladder tissues. Our method with high accuracy and better endurance could be applied to detect the lesions in bladder.